Menopause Care & Symptom Management

Menopause is a natural, physiological stage of life that marks the permanent end of menstruation. It is diagnosed after 12 months without a period. Menopause itself is not a disease, but its symptoms and its effects on bone, cardiovascular and genitourinary health may need assessment and treatment. Menopause care focuses on managing symptoms and long-term health, with advice that is individualized to each woman.

Common symptoms

• Hot flushes
• Night sweats
• Sleep problems and mood changes
• Vaginal dryness and urinary symptoms

Treatment options

Options are chosen after an individual assessment of symptoms, age, medical history and risks:

• Lifestyle measures such as exercise, a balanced diet and avoiding triggers for hot flushes
• Menopausal hormone therapy (MHT/HRT), where suitable
• Non-hormonal medicines for hot flushes, such as certain antidepressants, gabapentin or clonidine, which may be considered when hormone therapy is unsuitable or not preferred; their side effects are reviewed with you
• Vaginal moisturisers or local vaginal oestrogen for genitourinary symptoms
• Bone health: calcium, vitamin D and exercise, with bone density assessment and treatment for osteoporosis when indicated

Menopausal hormone therapy (HRT)

Hormone therapy can relieve hot flushes, night sweats and vaginal dryness, and helps to protect bone. It also carries risks, which depend on the type of hormone therapy, the dose, how long it is used, the age at which it is started and the woman’s health. These may include a higher risk of blood clots, stroke, gallbladder disease and, with long-term combined therapy, breast cancer. Hormone therapy is generally not suitable for women with a history of breast cancer, some other hormone-sensitive cancers, unexplained vaginal bleeding, active liver disease or previous blood clots, stroke or heart disease. The decision is made together with your doctor after weighing benefits, risks and your preferences, and the treatment is reviewed regularly.